1952390569 NPI number — DAVID A JONES MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952390569 NPI number — DAVID A JONES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JONES
Provider First Name:
DAVID
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952390569
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 E LIBERTY ST, STE 800
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOUISVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
40202-1428
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
502-633-3525
Provider Business Mailing Address Fax Number:
502-633-4067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 FAIRVIEW CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EMINENCE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
40019-1158
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-845-5672
Provider Business Practice Location Address Fax Number:
502-845-5076
Provider Enumeration Date:
10/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  25578 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0100491 . This is a "UHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000048275 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 64255789 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com